PURPOSE: To report an atypical presentation of sarcoidosis simulating birdshot chorioretinopathy. DESIGN: Observational case report. METHODS: Review of the clinical, laboratory, photographic, and histopathologic records of a patient with sarcoidosis. RESULTS: A 56-year-old white woman was evaluated for uveitis in both eyes. Dilated funduscopic examination of both eyes revealed numerous oval and irregular hypopigmented chorioretinal lesions located inferior nasally radiating from the optic nerve that were virtually identical to the typical funduscopic appearance of birdshot chorioretinopathy. The patient was lost to follow-up and returned 5 years later. In the interim, the patient underwent mediastinal lymph node biopsy that showed noncaseating granulomas consistent with sarcoidosis. The serum angiotensin-converting enzyme level was normal, and results of HLA- A29 testing were negative. CONCLUSIONS: Sarcoidosis can cause choroidal lesions similar to those of birdshot choroidopathy. Clinicians should consider sarcoidosis in the differential diagnosis of birdshot chorioretinopathy, and patients initially diagnosed with birdshot choroidopathy should also undergo workup for sarcoidosis.
PURPOSE: To report an atypical presentation of sarcoidosis simulating birdshot chorioretinopathy. DESIGN: Observational case report. METHODS: Review of the clinical, laboratory, photographic, and histopathologic records of a patient with sarcoidosis. RESULTS: A 56-year-old white woman was evaluated for uveitis in both eyes. Dilated funduscopic examination of both eyes revealed numerous oval and irregular hypopigmented chorioretinal lesions located inferior nasally radiating from the optic nerve that were virtually identical to the typical funduscopic appearance of birdshot chorioretinopathy. The patient was lost to follow-up and returned 5 years later. In the interim, the patient underwent mediastinal lymph node biopsy that showed noncaseating granulomas consistent with sarcoidosis. The serum angiotensin-converting enzyme level was normal, and results of HLA- A29 testing were negative. CONCLUSIONS:Sarcoidosis can cause choroidal lesions similar to those of birdshot choroidopathy. Clinicians should consider sarcoidosis in the differential diagnosis of birdshot chorioretinopathy, and patients initially diagnosed with birdshot choroidopathy should also undergo workup for sarcoidosis.
Authors: Luiz H Lima; Eric Shakin; Hatice N Sen; Robert B Nussenblatt; Lawrence A Yannuzzi; Lee M Jampol; Emmett T Cunningham Journal: Retina Date: 2010-04 Impact factor: 4.256